A Misclassification of Pulmonary Stenosis Using Conventional Echocardiographic Methods

Year 2018, Volume: 35 Issue: 1, 105 - 107, 01.01.2018

Tuğba Kemaloğlu Öz Mehmet Eren Tayfun Gürol Özer Soylu Bahadır Dağdeviren

https://izlik.org/JA86ME68SG

Abstract

Background: The classification of pulmonary stenosis (PS) severity based on the transpulmonary pressure gradient, which is affected by flow rate. Case Report: We report the first case of a pregnant patient with atrial septal defect (ASD) and pulmonary stenosis that was misclassified by conventional echocardiographic methods. Most importantly, three-dimensional transoesophageal echocardiographic assessment of pulmonary stenosis changed the entire treatment strategy. Conclusion: The planimetric calculation of the pulmonary valve (PV) opening area using three-dimensional transoesophageal echocardiographic may be helpful, especially in encounters with specialized conditions such as ASD and/or pregnancy, which can cause inaccurate recordings of the transvalvular peak gradient.

Keywords

Atrial septal defect , echocardiography , pregnancy , pulmonary stenosis , three-dimensional echocardiography

References

• . Webb G, Gatzoulis MA. Atrial septal defects in the adult: recent progress and overview. Circulation 2006;114:1645-53.
• 2. Camm AJ, Lüsher TF, Serruys WP. The ESC textbook of cardiovascular medicine. 2nd ed. New York: Oxford University Press; 2009.
• 3. Armstrong WF, Ryan T. Feigenbaum’s echocardiography. 7th ed. Philadelphia: Lippincott Williams and Wilkins; 2010:337-59.
• 4. Baumgartner H, Hung J, Bermejo J, Chambers JB, Evangelista A, Griffin BP, et al. Echocardiographic assessment of valve stenosis: EAE/ASE recommendations for clinical practice. Eur J Echocardiogr 2009;10:1-25.
• 5. Kemaloğlu Öz T, Özpamuk Karadeniz F, Akyüz Ş, Ünal Dayı Ş, Esen Zencirci A, Atasoy I, et al. The advantages of live/real time threedimensional transesophageal echocardiography during assessments of pulmonary stenosis. Int J Cardiovasc Imaging 2016;32:573-82.
• 6. Kemaloğlu Öz T, Karadeniz FÖ, Gundlapalli H, Erer B, Sharma RK, Ahmed M, et al. Coexisting bicuspid aortic and pulmonary valves with normally related great vessels diagnosed by live/real time three-dimensional transesophageal echocardiography. Echocardiography 2014;31:218-21.
• 7. European Society of Gynecology (ESG); Association for European Paediatric Cardiology (AEPC); German Society for Gender Medicine (DGesGM), Regitz-Zagrosek V, Blomstrom Lundqvist C, Borghi C, et al. ESC Guidelines on the management of cardiovascular diseases during pregnancy: the Task Force on the Management of Cardiovascular Diseases during Pregnancy of the European Society of Cardiology (ESC). Eur Heart J 2011;32:3147-97.
• 8. Stout K. Pregnancy in women with congenital heart disease: the importance of evaluation and counselling. Heart 2005;91:713-4.